Image Diagnosis: Abnormal Plain Films from the Emergency Department.
Gus M Garmel, MD, FACEP, FAAEM

In image 1, acute epiglottitis looks like a thumbprint at the level of the hyoid bone. Although now relatively rare in children, it can occur in adults and remains an airway emergency. In image 2, free air under both hemidiaphragms is an ominous sign. Although it may be present in postoperative patients and has been reported following vigorous sexual activities.
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Corridor Consult
Acute Phosphate Nephropathy.
Antoine Abcar, MD; Aviv Hever, MD; Jasminder S Momi, MD; John J Sim, MD

The risk for acute phosphate nephropathy is increased in patients with underlying chronic kidney disease, older age, and female sex; in patients taking angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, diuretics, nonsteroidal anti-inflammatory drugs; and after exposure to sodium-phosphate bowel-cleansing solutions.
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The Importance of Accurate Blood Pressure Measurement.
Joel Handler, MD

The most important commonly performed office test is blood pressure measurement, yet it is considerably undervalued. Populationwide, small inaccuracies in blood pressure measurement can have considerable consequences. Overestimating true blood pressure by 5 mm Hg would lead to inappropriate treatment with antihypertension medication in almost 30 million Americans, with attendant exposure to adverse drug effects, the psychological effects of misdiagnosis, and unnecessary cost.
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